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Notes/Jordan Abelard/Aug 5, 2026, 1:00 PM
JA

Note · Jordan Abelard

completedEVV pendingclient signed·Aug 5, 2026, 1:00 PM · 120 min
Service record
Jordan Abelard · Employment exploration
PDF
Aug 5, 20261:00 PM – 3:00 PM · 120 min · 8 unitsMaria Peterscompletedacceptedclient signed
Clock in
Aug 5, 2026, 1:00 PM
44.9823, -93.2566
Clock out
Aug 5, 2026, 3:00 PM
44.9825, -93.2640
Medications on 2026-08-05
  • 09:15Omeprazole20 mggiven
Level of interaction
Skills worked on
Daily activitiesPick each activity you did with Jordan
  • Assisted Jordan with developing and following a weekly activity schedule to reduce idle time and promote active daily routines
  • Assisted Jordan with coordinating transportation to events, appointments, and social outings
Support plan goals
Improve social skills
Did Jordan participate in a community outing?
Did Jordan start a conversation with a peer or staff member today?
Cook two meals a week
Did Jordan help plan or cook a meal today?
Progress review
signed by staff
Signatures
  • Caregiversigned Aug 5, 2026, 3:02 PM
  • Clientsigned with code Aug 5, 2026, 3:01 PM
  • Reviewaccepted on submission
Authorization SA-2026-00103PMI 12345678NPI 1234567893POS 12
Accepted Aug 5, 2026, 3:02 PM

Aggregator record

Exactly what the EVV aggregator and the 837P claim line receive

Provider tax ID
41-0000000
PMI #
12345678
Service code
T2019 U2
Units
8 × 15 min
Place of service
12 · Home
Rendering staff
Maria Peters · NPI 1234567893
Authorization
SA-2026-00103
Clock in
Aug 5, 2026, 1:00 PM
Clock out
Aug 5, 2026, 3:00 PM
GPS at clock in
44.98228, -93.25664 · ±8 m
GPS at clock out
44.98247, -93.26404 · ±10 m
Manual entry
No
Client signature
Signed with code Aug 5, 2026, 3:01 PM

Tasks

2 of 2 completed

  • Personal care / ADLs
  • Skill building per support plan

Shift note

Toured the Roseville library back office. Jordan shelved returns for 20 minutes with the volunteer coordinator and stayed on task throughout. Discussed transportation options for a possible volunteer slot.

Edit history

Kept with the note and exported as EVV evidence

No edits since creation.

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